What skills should simulation training in arthroscopy teach residents? A focus on resident input

Purpose   Our purpose was to identify what surgical skills trainees consider important to possess before performing in the operating room and the components of an optimal simulator.Methods   An online survey composed of 35 questions was completed by 67 orthopedic residents from across Canada. The questions examined the opinions of residents for their perspective on what constitutes an optimal design of an arthroscopic simulator.Results   The average year of residency of the respondents was 3.2, and the average number of arthroscopies assisted on was 66.1 with a range of 0–300. Identification of structures and navigation of the arthroscope were ranked highly in terms of importance for trainee surgeons to possess before performing in the operating room. Higher fidelity simulation models such as cadaveric specimens or the use of synthetic knees were preferred over lower fidelity simulation models such as virtual reality simulators or bench top models.Conclusion   The information from trainees can be used in the development of a simulator for medical education as well as program and curriculum design. The report also highlights the importance of the pre-RCT phases leading to the development of the most effective simulation programs.

[1]  Glenn Regehr,et al.  It’s NOT rocket science: rethinking our metaphors for research in health professions education , 2010, Medical education.

[2]  C Sutton,et al.  Learning rate for laparoscopic surgical skills on MIST VR, a virtual reality simulator: quality of human-computer interface. , 1999, Annals of the Royal College of Surgeons of England.

[3]  D. Kirkpatrick Evaluating Training Programs , 1994 .

[4]  P. Sandercock,et al.  Framework for design and evaluation of complex interventions to improve health , 2000, BMJ : British Medical Journal.

[5]  J. Barsuk,et al.  Does Simulation-Based Medical Education With Deliberate Practice Yield Better Results Than Traditional Clinical Education? A Meta-Analytic Comparative Review of the Evidence , 2011, Academic medicine : journal of the Association of American Medical Colleges.

[6]  Heather Carnahan,et al.  What skills should simulation training in arthroscopy teach residents? , 2008, International Journal of Computer Assisted Radiology and Surgery.

[7]  G. Regehr Highway spotters and traffic controllers: further reflections on complexity , 2011, Medical education.

[8]  H. Carnahan,et al.  Comparing self-guided learning and educator-guided learning formats for simulation-based clinical training. , 2010, Journal of advanced nursing.

[9]  David A Cook,et al.  Comparative Effectiveness of Technology-Enhanced Simulation Versus Other Instructional Methods: A Systematic Review and Meta-Analysis , 2012, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[10]  P. Dasgupta,et al.  How to develop a simulation programme in urology , 2011, BJU international.

[11]  M. Guadagnoli,et al.  Challenge Point: A Framework for Conceptualizing the Effects of Various Practice Conditions in Motor Learning , 2004, Journal of motor behavior.

[12]  R. Reznick,et al.  Teaching and testing technical skills. , 1993, American journal of surgery.

[13]  H. Carnahan,et al.  Coordinating Progressive Levels of Simulation Fidelity to Maximize Educational Benefit , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[14]  R. Reznick,et al.  Teaching surgical skills--changes in the wind. , 2006, The New England journal of medicine.

[15]  A. Darzi,et al.  Objective assessment of technical skills in surgery , 2003, BMJ : British Medical Journal.

[16]  Yeong Che Fai,et al.  Assessment Methods for Surgical Skill , 2011 .